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119 Cards in this Set

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Falciform ligament
connects liver to anterior abdominal wall
contains the ligamentum teres
Ligamentum teres
fetal remnant of umbilical vein
found in the Falciform ligament
Hepatoduodenal ligament
connects liver to duodenum
contains the portal triad: hepatic artery, portal vein, common bile duct
Gastrohepatic ligament
connects liver to lesser curvature of stomach
contains the gastric arteries
Gastrocolic ligament
connects the greater curvature of the stomach to the transverse colon
contains the gastroepiploic arteries
Gastrosplenic ligament
connects the greater curvature of the stomach to the spleen
does not contain any vessels
Splenorenal ligament
connects the spleen to the posterior abdominal wall
contains the splenic artery and vein
Medial umbilical ligaments
fetal remnant of umbilical arteries
Ligamentum venosum
fetal remnant of ductus venosus
Median umbilical ligament
fetal remnant of allantois (urachus)
Myenteric plexus
aka Auerbach's plexus
coordinates motility along entire gut wall.
Located between inner(circular) and outer(longitudinal) layers of smooth muscle in the muscularis externa
Auerbach's plexus
aka Myenteric plexus
coordinates motility along entire gut wall.
Located between inner(circular) and outer(longitudinal) layers of smooth muscle in the muscularis externa
Submucosal plexus
aka Meissner's plexus
Regulates local secretions, blood flow and absorption of GI tract
Located between mucosa and inner layer of smooth muscle in GI tract wall
Meissner's plexus
aka Submucosal plexus
Regulates local secretions, blood flow and absorption of GI tract
Located between mucosa and inner layer of smooth muscle in GI tract wall
Brunner's glands
Secrete alkaline mucus to duodenum
Indirect hernia
Goes through deep inguinal ring and superficial inguinal ring
Direct hernia
Protrudes through the inguinal(hesselbach's) triangle
Bulges directly through abdominal wall
Femoral hernia
Protrudes through femoral canal below and lateral to pubic tubercle
More common in women
Hesselbach's triangle
area bordered by the inferior epigastric artery (lateral/superiorly), the inguinal ligament (lateral/inferiorly), and the lateral boder of rectus abdominus (medially)
Site of protrusion in a direct inguinal hernia
Parietal Cells of stomach
Secrete Gastric acid(HCl) and intrinsic factor
Chief cells of stomach
Secrete pepsinogen which is a precursor to pepsin
Mucous neck cells of stomach
Secretes mucus to help protect the gastric mucosa
Smooth surface cells of stomach
secrete thick mucus w/ bicarbonate to provide a pH barrier to the gastric mucosa
Gastrin
Source: G cells of stomach antrum
Action: Increases gastric H+ secretion, growth of gastric mucosa and gastric motility
Regulation: secretion increased by stomach distension, amino acids, peptides, vagal stimulation and decreased by stomach pH <1.5
Cholecystokinin
Source: I cells of duodenum and jejunum
Action: Increases pancreatic secretion and gallbladder contraction; decreases gastric emptying
Regulation: Secretion decreased by secretin and increased by fatty acids, amino acids
Secretin
Source: S cells of duodenum
Action: Increases pancreatic bicarb secretion and decreases gastric acid secretion
Regulation: secretion increased by acid, fatty acids in lumen of duodenum
Somatostatin
Source: D cells of pancreatic islets and GI mucosa
Action: Decreases gastric acid and pepsinogen secretion, pancreatic and small intestine fluid secretion, gallbladder contraction, and insulin and glucagon release
Regulation: secretion increased by acid, decreased by vagal stimulation
GIP
Gastric inhibitory peptide
Source: K cells of duodenum and jejunum
Action: Decreases gastric H+ secretion and increases insulin release
Regulation: secretion increased b fatty acids, amino acids, oral glucose
VIP
Vasoactive intestinal polypeptide
Source: Parasympathetic ganglia in sphincters, gall bladder, small intestine
Action: Increases intestinal water and electrolyte secretion, relaxation of intestinal smooth muscle and sphincters
Regulation: secretion increased by distention and vagal stimulation and decreased by adrenergic input
Nitric Oxide
Action: Increases smooth muscle relaxation, including lower esophageal sphincter
What hormone is increased in Zollinger-Ellison syndrome
Gastrin
Increase in what hormone causes worsening of pain in patients w/ cholelithiasis after fatty food ingestion?
CCK
What hormone is used to treat VIPoma and carcinoid tumors
Somatostatin
VIPoma
non-alpha, non-beta islet cell pancreatic tumor that secretes VIP
Results in copious diarrhea
alpha-amylase
starch digestion
Secreted by the Pancreas
Lipase
fat digestion
Secreted by the Pancreas
Trypsin
Protein digestion
secreted as a proenzyme
Secreted by the Pancreas
Chymotrypsin
Protein digestion
secreted as a proenzyme
Secreted by the Pancreas
Elastase
Protein digestion
secreted as a proenzyme
Secreted by the Pancreas
Carboxypeptidase
Protein digestion
secreted as a proenzyme
Secreted by the Pancreas
Enterokinase
Duodenal brush border enzyme that converts trypsinogen to trypsin
Salivary amylase
starts digestion, hydrolyzes alpha-1,4 linkages to yield disaccharides
Glucose absorption
taken up by SGLT1(Na dependent) and GLUT-2
Oligosaccharide hydrolase
Intestinal brush border enzyme
RLS in carbohydrate digestion
Produces monosaccharides from oligo- and disaccharides
Galactose absorption
taken up by SGLT1(Na dependent) and GLUT-2
Fructose absorption
taken up by GLUT-5(Facilitated diffusion) and GLUT-2
Zone I of liver
Periportal zone
Area of portal vein and hepatic artery
Most sensitive to toxic injury
Affected first by viral hepatitis
Zone II of liver
Intermediate zone in between portal vein and central vein
Zone III of liver
Pericentral vein zone
Contains P-450 system
Affected first by ischemia
Celiac sprue a/w ____?
a/w T cell lymphoma and dermatitis herpetiformis
Tropical sprue
Malabsorption syndrome
Probably infectious
Responds to antibiotics
Can affect entire small bowel
Organism in Whipple's Disease?
Infection w/ Tropheryma whippelii
Acute gastritis
erosive inflamation of the stomach
caused by stress, NSAIDs, alcohol, uricemia, burns(curling's ulcer), and brain injury(cushing's ulcer)
Type A chronic gastritis
nonerosive inflamation of the stomach fundus/body
Autoimmune w/ autoantibodies to parietal cells, pernicious Anemia, and Achlorhydria
Type B chronic gastritis
nonerosive inflammation of the stomach antrum
caused by H. pylori infection
Increased risk of MALT lymphoma
Most common stomach cancer?
Adenocarcinoma
What is linitus plastica
diffusely infiltrative stomach cancer w/ thickened, rigid appearance
Krukenberg's tumor
bilateral metastases of stomach cancer to ovaries
Crohn's or ulcerative colitis:
terminal ileum and colon
Crohn's disease
Crohn's or ulcerative colitis:
skip lesions
Crohn's disease
Crohn's or ulcerative colitis:
"string sign" on barium swallow x-ray
Crohn's disease
Crohn's or ulcerative colitis:
can lead to fistulas
Crohn's disease
Crohn's or ulcerative colitis:
a/w migratory polyarthritis
Crohn's disease
Crohn's or ulcerative colitis:
a/w erythema nodosum
Crohn's disease
Crohn's or ulcerative colitis:
a/w ankylosing spondylitis
Crohn's disease
Crohn's or ulcerative colitis:
rectal sparing
Crohn's disease
Crohn's or ulcerative colitis:
continous lesions
Ulcerative colitis
Crohn's or ulcerative colitis:
Rectal involvement
Ulcerative colitis
Crohn's or ulcerative colitis:
Transmural inflammation
Crohn's disease
Crohn's or ulcerative colitis:
Mucosal and submucosal inflammation only
Ulcerative colitis
Crohn's or ulcerative colitis:
Mucosal pseudopolyps
Ulcerative colitis
Crohn's or ulcerative colitis:
a/w colorectal carcinoma
Ulcerative colitis
Crohn's or ulcerative colitis:
can lead to toxic megacolon
Ulcerative colitis
Crohn's or ulcerative colitis:
a/w pyoderma gangrenosum
Ulcerative colitis
Crohn's or ulcerative colitis:
a/w primary sclerosing cholangitis
Ulcerative colitis
Meckel's diverticulum
Persistance of the vitelline duct or yolk stalk
tumor marker for colorectal cancer
CEA
APC gene
chromosome 5q
leads to familial adenomatous polposis
Mallory bodies
intracytoplasmic eosinophilic inclusions in liver
a/w alcoholic hepatitis
AST>ALT
Alcoholic hepatitis
ratio usually > 1.5
ALT>AST
Viral hepatitis
only AST increased
Myocardial infarction
Increased alkaline phosphatase
Obstructive liver disease (hepatocellular carcinoma) and bone disease
Increased amylase and lipase
Acute pancreatitis
Decreased ceruloplasmin
Wilson's disease
Kayser-Fleischer rings
Corneal deposits of copper
Wilson's disease
Hemochromatosis a/w HLA ____?
HLA A3
Abesnt UDP-glucuronyl transferase
Crigler-Najjar syndrome, type I
Conugated hyperbilirubinemia w/ grossly black liver
Dubin-Johnson syndrome
Intra- and extrahepatic defect of bile ducts
Primary sclerosing cholangitis
"Beading" on ERCP
Primary sclerosing cholangitis
Intrahepatic defect of bile ducts
Primary Biliary Cirrhosis
Autoimmune disorder leading to obstructive jaundice
Primary Biliary Cirrhosis
Mitochondrial antibodies
Primary Biliary Cirrhosis
Primary Biliary Cirrhosis is a/w what?
scleroderma and CREST syndrome
Extrahepatic defect of bile ducts
Secondary Biliary Cirrhosis
Complications of Secondary Biliary Cirrhosis?
ascending cholantitis (bacterial infection), bile stasis, and "bile lakes"
Most common primary malignant tumor of liver
Hepatocellular carcinoma
Tumor marker for Hepatocellular Carcinoma
alpha-fetoprotein
Viruses a/w Reye's syndrome
VZV and influenza B
Most common type of Gallstone
Mixed stone- both cholesterol and pigment components
Type of Gallstone a/w:
Crohn's disease
Cholesterol stone
Type of Gallstone a/w:
Cystic Fibrosis
Cholesterol stone
Type of Gallstone a/w:
Native Americans
Cholesterol stone
Type of Gallstone a/w:
Estrogens
Cholesterol stone
Type of Gallstone a/w:
Rapid weight loss
Cholesterol stone
Type of Gallstone a/w:
Chronic RBC hemolysis
Pigment stone
Type of Gallstone a/w:
Alcoholic cirrhosis
Pigment stone
Type of Gallstone a/w:
Biliary infection
Pigment stone
Lab values in acute pancreatitis
Increased amylase and lipase
Lipase is more specific
Chronic calcifying pancreatitis is a/w what?
Alcoholism
Chronic obstructive pancreatitis is a/w what?
Gallstones
What type of cancer forms in the pancreas?
Adenocarcinoma
Prognosis for Pancreatic adenocarcinoma
averages 6 months of less
Patient usually has metastases by the time of presentation
What individuals are a/w increased risk of pancreatic adenocarcinoma
Jewish and African-American males
Courvoisier's sign
Obstructive jaundice w/ palpable gallbladder
Trousseau's syndrome
Migratory thrombophlebitis
Pancreatic adenocarcinoma is a/w use of what?
cigarettes
pancreatic adenocarcinoma is not a/w EtOH
Symptoms of Carcinoid
Wheezing, right-sided heart lesions, diarrhea, flushing